Cardiovascular Manifestations of Primary Hypothyroidism

Abstract

Introduction: Hypothyroidism is a clinical syndrome that results from decreased secretion of thyroid hormone from thyroid gland. Primary hypothyroidism accounts for 90-95% of all cases of hypothyroidism. Hypothyroidism has various cardiovascular manifestations. This study was conducted with an aim to identify cardiovascular manifestations of hypothyroidism for an early prevention and management.
Methods: A cross sectional observational study was conducted in Department of Medicine in Bir Hospital. Ethical clearance was taken from Institutional Review Board National Academy of Medical Sciences. A total of 70 patients with untreated primary hypothyroidism without any prior known comorbidities or under any medication were randomly selected. Data were collected and entered in Microsoft Excel to tabulate data and analyze results.
Results: Out of 70 enrolled participants, 41 cases had sub-clinical hypothyroidism and 29 overt/clinical hypothyroidism with male to female ratio of 4:1. Most common presenting cardiovascular symptoms was peripheral edema (60%) followed by easy fatigability (47.14%). Body mass index (BMI) and blood pressure was elevated in 70% and 60% of participants respectively. Dyslipidemia was present in 48.57% of cases among which majority changes were in triglyceride and total cholesterol level. Abnormality in ECG was seen in only 22.85% of cases with T wave abnormality (18.57%) being most common followed by sinus bradycardia (14.28%). Echocardiography was abnormal in 7.14% of cases with 2.86% showing pericardial effusion.
Conclusions: Cardiovascular manifestations were present in majority of patients of primary hypothyroidism especially High BMI, Hypertension and Dyslipidemia. The newly diagnosed primary hypothyroidism patients should be screened routinely for cardiovascular manifestations.